Archived: Prince George Duke of Kent Court

Updated 28 July 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 04 and 05 July 2016 and was unannounced. The inspection team consisted of an adult social care inspector, a specialist advisor with a background in nursing and an expert by experience on the first day. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The adult social care inspector returned to the service on the second day to complete the inspection.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

Prior to our inspection we looked at the information we held about the service. This included the PIR and information from any notifications submitted to the Commission by the service. A notification is information about important events that the provider is required to send us by law. We also asked the local authority commissioners for their views about the service. We used this information to inform our inspection planning.

During our inspection we used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spent time observing the care and support being delivered.

We spoke with eleven people living at the service, two relatives, one visitor, two visiting community nurses and eight staff including the registered manager. We observed how care was provided and looked at records, including 11 people’s care records, eight staff recruitment records and other records relating to the management of the service.

Updated 28 July 2016

This inspection took place on 04 and 05 July 2016 and was unannounced. At our last comprehensive inspection on 01 and 03 December 2015 we found breaches of legal requirements because risks to people had not always been safely managed and people’s risk assessments were not up to date. Staff had not always been deployed in a way to ensure there were sufficient numbers to meet people’s needs. Mental capacity assessments had not always been conducted appropriately in line with the requirements of the Mental Capacity Act 2005 (MCA) and referrals had not always been made promptly to healthcare professionals where required in support of people’s health. The provider wrote to us following that inspection and told us the action they would take to address these breaches.

At this inspection we found that improvements had been made in these areas and that the provider was compliant with the relevant regulations. However we also found a further breach of regulations because the systems used to monitor and mitigate risks to people did not always identify areas of risk promptly and because audits of people’s care plans did not always identify issues.

Prince George Duke of Kent Court is a nursing and residential home providing accommodation, care and support for up to 78 people. At the time of our inspection there were 71 people living at the service. There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We found that risks to people had been assessed and were safely managed, although improvement was required to ensure there was sufficient guidance for staff on how to manage identified risks. Improvement was also required to the management of people’s records, to ensure they were consistent and could be located promptly when required. People’s medicines were stored and administered safely as prescribed. Staff had received training in safeguarding adults and knew the action to take if they suspected abuse had occurred.

The provider followed safe recruitment practices and there were sufficient staff deployed within the service to meet people’s needs. People had access to a range of healthcare professionals when required and healthcare professionals we spoke with told us staff worked well to meet people’s health needs. People were supported to maintain a balanced diet.

Staff were aware of the importance of seeking consent from the people they supported and the provider followed the requirements of the MCA where people lacked capacity to ensure decisions were made lawfully in people’s best interests. Where required, people were lawfully deprived of the liberty in their best interests under the Deprivation of Liberty Safeguards (DoLS).

People were treated with kindness and consideration and told us they were involved in day to day decisions about their care and treatment. Staff treated people with dignity and respected their privacy. Staff were supported in their roles through training and regular supervision.

People’s care plans were reviewed on a regular basis to ensure they remained reflective of their current needs and views. There was a range of activities available to people at the service. People told us they knew how to complain and any complaints received by the service had been dealt with appropriately in line with the provider’s policy and procedure.

People were able to express their views about the service through regular residents meetings and by completing an annual survey. People told us they felt listened to and that action was taken in response to their feedback. People and staff also spoke positively about the leadership of the service and we saw that an ongoing programme of improvements was in place.